New regulations force local mental health agency to make cutbacks

While other mental health care providers across Washington have been forced by funding changes to not only cut services, but close facilities, Central Washington Comprehensive Mental Health has managed to find a way to continue plugging along.

Central Washington Comprehensive Mental Health CEO Rick Weaver, who works out of the Yakima office of the agency, explained that funding changes are forcing facilities across the state to change the way they do business.

Most of the changes being implemented deal with Medicaid funding.

Weaver explained that before changes were made to the way the state dealt with Medicaid funds, the state had been doing a good job of using the federal funds they received to leverage more dollars.

The leveraged dollars were then used to help provide mental health services not only to people who received Medicaid, but also to those who didn't. That has since changed.

Weaver said Medicaid funds can now only be used to help those who qualify for the funds.

This means that the only people who can receive access to mental health services are those who can pay for the full cost of the care out of their own pocket, or through the use of insurance or Medicaid.

Those who can't pay for regular mental health services can still receive emergency services. Weaver explained that emergency services are paid for through state funds, not federal.

Weaver said those who require emergency services are people who are acutely mentally ill or are gravely disabled and can't take care of their own basic needs.

"If someone meets these criteria it's an emergency," Weaver said.

Although Central Washington Comprehensive Mental Health has been forced to only provide services to those who can pay for the full cost of care, Weaver said the agency's clients still have an option.

Weaver said the local mental health provider offers service scholarships, when they are available, to those who otherwise wouldn't be able to afford care.

Although the recent changes to the mental health industry have made these service scholarships important, Weaver said the scholarships are something Central Washington Comprehensive Mental Health has always strived to have available.

"We have an active effort all the time," Weaver said of raising money for the service scholarships.

Another change that has recently taken effect deals with the criteria that is used to determine whether or not someone is eligible for service.

The Federal Centers for Medicare and Medicaid Services recently made the state come up with a criteria for services, which determines what criteria a person must meet in order to quality to receive mental health services.

Which the state did. The state created its basic criteria with the thought that mental health care providers could provide more services if they found ways to stretch their resources.

According to Weaver, although Central Washington Comprehensive Mental Health was able to make the most of its resources, the Federal Centers for Medicare and Medicaid Services decided that it would only allow service providers to use the exact criteria created by the state to determine service eligibility.

Since the beginning of the year, when Central Washington Comprehensive Mental Health put into effect the changes, Weaver said it had to deny services to nearly 500 people.

He said nearly 150 people who used to be eligible for services were told as of Jan. 1 that they were no longer eligible. According to Weaver, since January the local mental health agency has had to turn away another 350 people who would have previously received service.

Although Central Washington Comprehensive Mental Health has had to turn potential clients away, it has still managed to keep providing services to a majority of its clients and hasn't been forced to close any of its facilities.

"It's devastating in that 500 people are not getting service," Weaver said. "But the very sickest people are still getting care. We've minimized the damage."

Weaver said one of the reasons the local mental health agency has had time to prepare for the funding changes is because it was something they saw coming down the line more than two years ago.

"We started making our efforts in 2003," Weaver said. "We knew it was coming."

He added that most of the changes that have occurred were first scheduled to go into effect on Jan. 1 of this year. Instead of sitting back and watching the date approach, Weaver said his organization spent months trying to raise the funds necessary to continue the operation of Central Washington Comprehensive Mental Health's six centers, including the one in Sunnyside.

According to Weaver, by the time the Jan. 1 deadline approached, enough money had been raised to keep the Sunnyside branch open for two months, while the state legislature worked to determine if it would be able to provide funds to help.

In the end, Weaver said the legislators came through and because the Sunnyside branch was still in operation when the funds became available, keeping the facility open proved not to be a problem. Weaver said other mental health providers across the state were not as lucky. He explained that many mental health providers closed facilities on Jan. 1 because of a lack of funding, and when the state funds came through they were unable to reopen their facilities.

Although Central Washington Comprehensive Mental Health has had these changes in place since Jan. 1, Weaver explained that due to a last minute reprieve on Dec. 31, 2004, the new regulations ended up not officially going into effect until July 1.